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Humeral shaft fracture

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https://www.readbyqxmd.com/read/28526166/transhumeral-anterior-radial-nerve-transposition-to-simplify-anticipated-future-humeral-reconstruction
#1
REVIEW
David A Muzykewicz, Reid A Abrams
Anterior transhumeral radial nerve transposition has been described in the treatment of humeral shaft fracture to protect the nerve from implant irritation or callus entrapment. Transposing the radial nerve through a facilitating humeral defect also simplifies revision surgery should nonunion result. Here we describe a surgical technique for anterior transhumeral radial nerve transposition for complex humeral reconstruction when subsequent revision surgery is anticipated. Three cases are used for illustration: (1) revision of a total elbow arthroplasty with periprosthetic fracture; (2) revision of a total elbow arthroplasty after aseptic loosening from an allograft/prosthesis composite; and (3) septic humeral nonunion with substantial bone loss...
May 16, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28499398/biomechanical-evaluation-of-a-novel-dualplate-fixation-method-for-proximal-humeral-fractures-without-medial-support
#2
Yu He, Yaoshen Zhang, Yan Wang, Dongsheng Zhou, Fu Wang
BACKGROUND: Comminuted fractures of the proximal humerus are generally treated with the locking plate system, and clinical results are satisfactory. However, unstable support of the medial column results in varus malunion and screw perforation. We designed a novel medial anatomical locking plate (MLP) to directly support the medial column. Theoretically, the combined application of locking plate and MLP (LPMP) would directly provide strong dual-column stability. We hypothesized that the LPMP could provide greater construct stability than the locking plate alone (LP), locking plate combined with a fibular graft (LPSG), and locking plate combined with a distal radius plate (LPDP)...
May 12, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28486287/controlled-compression-nailing-for-at-risk-humeral-shaft-fractures
#3
J Tracy Watson, Roy W Sanders
Compression techniques seem to be the primary factor in determining the success of both plating and nailing techniques for the management of acute fractures and for delayed and nonunion management of these fractures. An intramedullary nail that can provide continual compression (like a plate) and mechanical manipulation of the callous throughout the course of treatment is an ideal device that provides all the advantages of plating and nailing and avoids the noted limitations of both. The UNYTE compression humeral nail is based on the PRECICE intramedullary limb lengthening system...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28484909/humeral-shaft-fractures-national-trends-in-management
#4
Bradley S Schoch, Eric M Padegimas, Mitchell Maltenfort, James Krieg, Surena Namdari
BACKGROUND: The incidence of humeral shaft fractures has been increasing over time. This represents a growing public health concern in a climate of cost containment. The purpose of this study is to analyze national trends in surgical management of humeral shaft fractures and determine factors predictive of surgical intervention. MATERIALS AND METHODS: Humeral shaft fractures were identified by the International Classification of Diseases, Ninth Revision, Clinical Modification codes 812...
May 8, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28461960/radial-nerve-palsy
#5
Marko Bumbasirevic, Tomislav Palibrk, Aleksandar Lesic, Henry DE Atkinson
As a result of its proximity to the humeral shaft, as well as its long and tortuous course, the radial nerve is the most frequently injured major nerve in the upper limb, with its close proximity to the bone making it vulnerable when fractures occur.Injury is most frequently sustained during humeral fracture and gunshot injuries, but iatrogenic injuries are not unusual following surgical treatment of various other pathologies.Treatment is usually non-operative, but surgery is sometimes necessary, using a variety of often imaginative procedures...
August 2016: EFORT Open Rev
https://www.readbyqxmd.com/read/28417290/unilateral-external-fixator-in-the-treatment-of-humeral-shaft-fractures-results-of-a-single-center-retrospective-study
#6
M Basso, M Formica, L Cavagnaro, M Federici, M Lombardi, F Lanza, L Felli
BACKGROUND: The aim of our work is to evaluate and critically analyze long-term clinical and radiological data of a new unilateral external fixator (MIKAI KIT FEP©-Mikai S.p.A, Genoa, Italy), in the treatment of humeral shaft fractures. MATERIALS AND METHODS: We reviewed 47 patients affected by humeral fractures that underwent surgery from July 2010 to March 2016 with unilateral external fixator. Demographic characteristics of the patients were recorded, which included age, sex and baseline comorbidities and mechanism of injury...
April 17, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28409214/-fractures-of-the-upper-limbs-in-childhood-and-adolescence
#7
P P Schmittenbecher
Fractures of the upper limbs are frequent and often need operative treatment in addition to a well-indicated conservative management. This depends on the maturity of the nearest growth plate and the local remodeling potential, which is dependent on age. Following conventional x‑ray imaging an individual prognostic growth analysis leads to the therapeutic decision. Around the elbow and the shaft of the forearm, criteria are stricter than near the shoulder or wrist. Gilchrist or Desault bandages as well as braces are adequate for most subcapital and humeral shaft fractures...
May 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28375900/an-excellent-study-of-operative-versus-nonoperative-treatment-of-humeral-shaft-fractures-commentary-on-an-article-by-fabio-teruo-matsunaga-md-phd-et-al-minimally-invasive-osteosynthesis-with-a-bridge-plate-versus-a-functional-brace-for-humeral-shaft-fractures
#8
https://www.readbyqxmd.com/read/28375891/minimally-invasive-osteosynthesis-with-a-bridge-plate-versus-a-functional-brace-for-humeral-shaft-fractures-a-randomized-controlled-trial
#9
RANDOMIZED CONTROLLED TRIAL
Fabio Teruo Matsunaga, Marcel Jun Sugawara Tamaoki, Marcelo Hide Matsumoto, Nicola Archetti Netto, Flavio Faloppa, Joao Carlos Belloti
BACKGROUND: Nonoperative treatment has historically been considered the standard for fractures of the shaft of the humerus. Minimally invasive bridge-plate osteosynthesis for isolated humeral shaft fractures has been proven to be a safe technique, with good and reproducible results. This study was designed to compare clinical and radiographic outcomes between patients who had been treated with bridge plate osteosynthesis and those who had been managed nonoperatively with a functional brace...
April 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28370473/-half-folded-pedicled-scapular-bone-flap-for-nonunion-after-humeral-neck-fracture-a-case-report
#10
Gen Matsumae, Makoto Motomiya, Naoya Watanabe, Norimasa Iwasaki
Treatment of a nonunion of the proximal humerus remains a challenge because of the small proximal fragment and poor central cancellous bone stock of the humeral head. In this report, we describe our experience using a "half-folded" pedicled scapular bone flap with an anatomical locking plate to treat an atrophic nonunion of the proximal humerus in a 64-year-old right-handed woman. The patient had fallen and experienced a common humeral neck fracture 2.5 years previously. During the operation, we elevated the pedicled scapular bone flap, which measured 8...
March 28, 2017: Microsurgery
https://www.readbyqxmd.com/read/28359639/lateral-para-olecranon-approach-for-the-treatment-of-distal-humeral-fracture
#11
Takuji Iwamoto, Taku Suzuki, Noboru Matsumura, Masaya Nakamura, Morio Matsumoto, Kazuki Sato
PURPOSE: To assess the outcomes of the lateral para-olecranon triceps-splitting approach for the treatment of distal humeral fracture. METHODS: Ten patients (3 males, 7 females) with a mean age of 59 years were retrospectively reviewed. There were 2 A2, 3 C1, and 5 C2 fractures according to the AO/ASIF classification. Types B3 and C3 fractures were excluded from this study because the olecranon osteotomy approach was indicated to visualize the anterior fragment...
May 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28333947/surgical-interventions-to-treat-humerus-shaft-fractures-a-network-meta-analysis-of-randomized-controlled-trials
#12
Jia-Guo Zhao, Jia Wang, Xiao-Hui Meng, Xian-Tie Zeng, Shi-Lian Kan
BACKGROUND: There are three main surgical techniques to treat humeral shaft fractures: open reduction and plate fixation (ORPF), intramedullary nail (IMN) fixation, and minimally invasive percutaneous osteosynthesis (MIPO). We performed a network meta-analysis to compare three surgical procedures, including ORPF, IMN fixation, and MIPO, to provide the optimum treatment for humerus shaft fractures. METHODS: MEDLINE, EMBASE, Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, and Cochrane library were researched for reports published up to May 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28330797/flexible-intramedullary-nailing-for-treatment-of-proximal-humeral-and-humeral-shaft-fractures-in-children-a-retrospective-series-of-118-cases
#13
Z Pogorelić, S Kadić, K P Milunović, I Pintarić, M Jukić, D Furlan
BACKGROUND: The aim of this study was to analyze outcomes of treatment and complications in children treated with flexible intramedullary nailing (FIN) due to humeral fracture. HYPOTHESIS: The FIN for treatment of humeral fractures in children would allow an early functional and cast-free follow-up with a quick pain reduction and low complication rate. PATIENTS AND METHODS: From May 2002 until May 2016 case records of all children who underwent fixation with titanium intramedullary nails because of humeral fracture were retrospectively reviewed...
March 19, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28293910/surgical-treatment-of-complex-proximal-humeral-fractures-with-a-technique-of-nail-and-osteosuture-nos
#14
J Garret, H Houdré, M Cievet-Bonfils, Arnaud Godenèche, Fabrice Duparc, Xavier Roussignol
Open reduction and internal fixation of complex proximal humeral fracture represents a surgical challenge. The main objective of this procedure is to anatomically reduce the tuberosities. We propose a standardized and reproducible technique that we apply to all complex displaced 3- and 4-part fractures of patients under 50 years. We use an antero-lateral trans-deltoid approach; the humeral head and the tuberosities are reduced under fluoroscopic control. The tuberosities are stabilized with an inter-tuberosity osteosuture, and we then introduce a thin and straight intra-medullary nail (Telegraph IV FH Orthopedics) at the hinge point of the humeral head...
March 14, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28280873/radial-nerve-palsy-in-humeral-shaft-fractures-with-internal-fixation-analysis-of-management-and-outcome
#15
T R Schwab, P F Stillhard, S Schibli, M Furrer, C Sommer
INTRODUCTION: The incidence of radial nerve injury after humeral shaft fractures is on average 11.8% (Shao et al., J Bone Jt Surg Br 87(12):1647-1652, 2005) representing the most common peripheral nerve injury associated with long bone fractures (Korompilias et al., Injury, 2013). The purpose of this study was to analyze our current policy and long-term outcome, regarding surgically treated humeral shaft fractures in combination with radial nerve palsy. MATERIALS AND METHODS: We retrospectively analyzed the data of patients with surgically treated humeral shaft fractures from 01/01/2003 to 28/02/2013...
March 9, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28236247/humeral-shaft-non-union-after-intramedullary-nailing
#16
G Campochiaro, P Baudi, M Gialdini, A Corradini, V Duca, M Rebuzzi, F Catani
BACKGROUND: The humerus shaft is one of the sites with the largest probability of developing pseudoarthrosis after fracture. We present the results of nine patients with atrophic pseudoarthrosis of humeral shaft treated with angular stability plate associated with allograft and platelet-rich plasma (PRP), after a first treatment with intramedullary nail to correct the fracture. MATERIAL AND METHODS: From January 2012 to December 2014, nine patients were treated for atrophic pseudoarthrosis (PSA) of humeral shaft treated previously using intramedullary nail; seven humeral diaphysis fractures were located in the middle-proximal third and two in the middle third...
February 24, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28216756/outcome-of-anatomic-locking-plate-in-extraarticular-distal-humeral-shaft-fractures
#17
Deepak Jain, Gurpreet S Goyal, Rajnish Garg, Pankaj Mahindra, Mohammad Yamin, Harpal S Selhi
BACKGROUND: Extraarticular fractures of distal humerus are challenging injuries to treat because of complex anatomy and fracture patterns. Functional bracing may not provide adequate stability in these injuries and operative treatment with intramedullary nails or conventional plates also has the limitation of inadequate fixation in the short distal fragment. The 3.5 mm precontoured single column locking plate (extraarticular distal humerus plate [EADHP]) has been introduced to overcome this problem...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28131681/intraobserver-and-interobserver-agreement-in-the-classification-and-treatment-of-proximal-humeral-fractures
#18
Mauro E C Gracitelli, Thiago A G Dotta, Jorge H Assunção, Eduardo A Malavolta, Fernando B Andrade-Silva, Kodi E Kojima, Arnaldo A Ferreira Neto
BACKGROUND: There is controversy surrounding the reliability of radiographic measurements and existing classifications for proximal humeral fractures. METHODS: Ten orthopedists, divided into 2 groups by length of experience, evaluated radiographs in 3 views from 40 proximal humeral fractures. We evaluated 11 radiographic criteria (including the Neer and pathomorphologic classifications, head-shaft angle, displacement of the humeral shaft, and lesser and greater tuberosities) and treatment indication...
January 25, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28120001/numerical-investigation-of-fracture-impaction-in-proximal-humeral-fracture-fixation-with-locking-plate-and-intramedullary-nail
#19
Yen-Nien Chen, Chih-Wei Chang, Chia-Wei Lin, Chih-Wei Wang, Yao-Te Peng, Chih-Han Chang, Chun-Ting Li
INTRODUCTION: Fracture impaction is a surgical technique used to support the fractured humerus with locking plate or intramedullary nail when treating proximal humeral fractures. However, few studies have investigated the mechanical difference between fracture impaction with locking plate and with intramedullary nail. The mechanism of fracture impaction to increase stability is still unclear. The aim of this study was to use numerical methods to compare the biomechanical effect of treating proximal humeral fracture...
January 24, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28109556/minimally-invasive-lateral-plate-placement-for-metadiaphyseal-fractures-of-the-humerus-and-its-implications-for-the-distal-deltoid-insertion-it-is-not-only-about-the-radial-nerve-a-cadaveric-study
#20
Emanuel Benninger, Christoph Meier
INTRODUCTION: Minimally invasive lateral placement of plates on the humerus may be associated with a risk of injury to the radial nerve. Whereas this potential complication has been investigated in several studies, there is no data regarding potential injuries to the distal insertion of the deltoid muscle when the plates are passed distally in a submuscular tunnel. METHODS: Minimally invasive plate placement was performed on eight arms in fresh cadavers. A lateral deltoid split approach was made and the plates were introduced in an antegrade submuscular manner from proximal to distal...
January 13, 2017: Injury
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